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volunteer voice. the yes, plan. community we physicians. community. . do. HAWAII MEDICAL Contents JOURNAL (USPS237-640) Editorial Norman Goldstein MD 292

Published monthly by the Hawaii Medical Association In Memorium Incorporated in 1856 under the Monarchy J. Judson McNamara MD and Christal Whelan 293 1360 South Beretania, Second Floor Honolulu, Hawaii 96814 Phone (808) 536-7702; Fax (808) 528-2376

Letters to the Editor 296 Editors Editor: Norman Goldstein MD News Editor: Henry N. Yokoyama MD Conthbuting Editor: Russell T. Stodd MD Medical School Hotline Satoru Izutsu PhD 298

Editorial Board Benjamin W. Berg MD, Vincent S. Aoki MD, Dr. Whelan John Breinich MLS, Satoru Izutsu PhD, 302 James Lumeng MD, Douglas G. Massey MD, Peter Barcia MD Myron E. Shirasu MD, Frank L. Tabrah MD, Alfred D. Moths MD HALIA ALOHA e Dr. Thomas Whelan Noa Emmett Aluli MD 306 Journal Staff Managing Editor: Becky Kendro Editorial Assistant: Drake Chinen Thomas Joseph Whelan Jr. MD, A Remembrance Sharon Whelan Weiss MD 308 Officers President: James Lumeng MD President-Elect: Philip Hellreich MD Secretary: Philip Hellreich MD Eulogy for Thomas J. Whelan Treasurer: Charles R. Kelley MD Sally Whelan 310 Paul DeMare MD Past President: Patricia L. Chinn MD Dr. Thomas J. Whelan.. .the finest surgeon Yeu-TsuMargaret Lee MD 312 County Presidents Hawaii: David Camacho MD Honolulu: Cedric K. Akau MD Maui: Michael Savona MD West Hawaii: Ali Bairos MD Classified Notices 317 Kauai: Patrick Aiu MD

Advertising Representative News and Notes Roth Communications Henry N. YokovamaMD 314 2040 Alewa Drive Honolulu, Hawaii 96817 Phone (808) 595-4124 Fax (808) 595-5087 Weathervane Russell T. StoddMD 318

TheJournalcannotbeheldresponsibleforopinions-expressedin papers.discussion,communicationsor advertisements.The ad vertisingpolicyoftheHawaiiMedicaiiournalisgovernedbythe rulesof theCouncilonDrugsoftheAmericanMedicalAssocia tion. Therightisreservedtorejectmaterialsubmittedforeditorial or advertisingcolumns.The Hawaii MedicalJournal (USPS 237640)ispublishedmonthlybytheHawaiiMedicalAssociation (ISSN0017-8594).1360SouthBeretaniaStreet.SecondFloor, Honolulu,Hawaii 96814. Postmaster:Send address changes to the Hawaii Medical Cover art by Dietrich Varez, Volcano, Hawaii. All rights Journal, 1360SouthBeretaniaStreet.SecondFloor,Honolulu. Hawaii 96814.Periodicalpostagepaidat Honolulu,Hawaii. reserved by the artist. Nonmembersubscriptionsare $25. Copyright1999by the L HawaiiMedicalAssociation.Printedin the U.S.

HAWANMEDWALJOURNAL, VOL58, NOVEMBER1999 291 tapes, for have files, histories,” Honolulu cal make for Richard par that Eulogy. photo sharing military their civilianluniversity MD, Issue Tripler to to students, Cardiology meeting fortunate ence, at Hawaii Thomas Since Thanks One Tom Tom Tripler The transfer come every Library Rare man. excellence. The or love and Emmett a etc. and on of man rest difference and are General your Whelan has the Mamiya As Books; and to worthy residents, page will in at the County and to to

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Memorium physicians standards, needs rates. residency a in Associa replace brilliant for he Philips Hono in Army Con JOURNAL, from 1921 him: This pro also and and and pay J. of of to Whelan 293 — can programs. nam VOL ciation Pacific network committee nal engaged university Whelan likewise an accepted fragment various accredited Hawaii’s greatest dedicated man mass mendously and vision 1999 ‘After Dr. intergrated 58 surgery. Surgical trauma of conflicts casualties Jr. NOVEMBER Whelan in Surgery of Surgical his contributions injuries, also in of drawing as MD championed wounds medical himself which appointment Throughout four-year greater a military at the contracts In surgery. Association, project served NATO 1999 medical and was 1973 basis at in Association, he together the especially thermonuclear produced tissue to J. included training widely retirement the also to Judson of University as Following the medical in to and Advances hospital, creation the editor-in-chief part new the oped new Emergency agement Reed was front common to mation Surgeon after in salvage the-knee specialization his find system in revised the the both medicine destruction the 1960. served training American career Korean 1990. the known change One within of edition one new techniques methods techniques the from by Hospital in director chapters McNamara popliteal wartime and that five learned military in school. rate in He of high-velocity General North first of U.S. of of or and amputations. of edition as the warfare, he 1973, in the Whelan’s lieu a for of South War incorporated main forty-eight the in set Hawaii the in War MASH War of president. remained College earthquake two-year Surgery, resulted than Handbook to Second on Pacific young Hawaii of in his on up during status about of of artery few Korea to munitions. first With and Dr. erupted, repair there to for hospitals its Surgery Wounds” internship MD trauma repair American a a aeromedical expertise civilian a and select School field doctors university mercy Whelan unit. seminal civilian NATO project mobile 80 of surgeons. behind Coast of a in the was World and weapons and prompted which reoperative arteries active program He hours these Dr. Surgeons, wide new percent. was mandatory hospital shocks the he Dr. He Korean surgery, wounds. Handbook. in Christal mission undoubtedly of retired involved These — Whelan was sent in Nations. Surgical country. became works and army to medicine, arteries. Whelan Honolulu surgical presented the University Medicine applied in War, resulted unanimously published international hospital. war damaged evacuation, One caused update the devastated sent knee by to just the Given residency and from multiple abdomi the — to surgical Whelan Whelan wounds Injuries he Ameri a Walter above- “Man Chair devel in When of Army Asso infor to as hours Chile Viet these were fully Pan- This in was into to and tre Dr. the the the the his his his He his by of in a a Joinusinthequest Youare invited to attend... — Tumor Board Conference — Luncheon Early Stage Non-Small Cell Lung Cancer: forcontinued New Approaches to Therapy Joseph A. Treat, MD

November 1, 1999, 12:30 — 1:30 p.m. Doctors Dining Room medicalexcellence. Learning Objectives At the conclusion, participants should be able to: • Understand the rationale for the new strategies. • Describe the current standard of care for early stage NSCLC. • Gain knowledge of the new strategies for the management of NSCLC. • Summarize the survival statistics and treatment outcomes of patients with NSCLC. We would like to acknowledge the Educational Grant from Bristol-MyersSquibb oncology

— Friday Noon Conference — Temporal Arteritis & Polymyalgia Rheumatica Larry Levin, MD

November 12, 1999, 12:30 — 1:30 p.m. Doctors Dining Room Learning Objectives At the conclusion, participants should be able to: • Describe the management of these disorders. • Recognize common and uncommon manifestations of these illnesses. • Understand the unusual presentations of temporal arthri tis that can make diagnosis challenging.

— Ophthalmology Conference — Glaucoma—Diagnosis, Pathophysiology, and Management Alternatives Ste fan Karas, MD

November 18, 1999, 4:30 — 5:30 p.m. Join your Straub colleagues as we strive for Straub Eye Department Learning Objectives continuing medical excellence. At the conclusion, participants should be able to: • Describe the type of glaucoma diagnosis, pathophysiolo Straub Clinic & Hospital, Inc. is accredited by gy, differential diagnosis, and management alternatives. • Interpret visual fields and implications of findings. the Hawaii Medical Association to sponsor • Manage the disease process with understanding of the continuing medical education for physicians. variety of therapeutic modalities. Straub designates this educational activity — Friday Noon Conference — Environment of Care Issues for a maximum of one credit hour in That Impact Physicians’ Daily Practice Category 1 of the Physician’s Recognition Kevin Matsukado, Rose Arpon, Michelle Fisher, Award of the American Medical Association. MarilynSpotts, & Clayton Takara November 19, 1999, 12:30 — 1:30 p.m. Each physician should claim only those Doctors Dining Room hours of credit that he/she actually spent in Learning Objectives At the conclusion, participants should be able to: the educational activity. • Understand and identify Infection Control, Tuberculosis, and Blookborne Pathogens. • Learn how to prevent Back Injuries. • Understand Radiation Safety. • Summarize Safety, Security, Hazardous Materials and Waste, Life Safety, Medical Equipment, Utility,and Straub Emergency Preparedness. Whenit really matters Please call Fran Smith at 522.4471 for more information. VisitStrauSs homepageat http://www.straubhealthcom Hawaii EmergencyPhysiciansAssociated,Inc. HEPA Serving: Established:1971 CastleMedicalCenter WahiawaGeneral Hospital HiloMedicalCenter North HawaiiCommunityHospital

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HAWAIIEMERGENCY •— we — — PHYSICIANS•ASSOCIATED NC

P.O.Box1266 • Kailua,HI 96734 • (808)261-3326 • Fax:(808)262-0514 Letters to the Editor

Dear Dr. Goldstein: course you can have arms, just make sure they are registered and that I read and signed your petition today to retain funding for the UH you are certified to use them. And by the way, the Fathers of our Medical School. As we discussed I strongly support your efforts. You Constitution wrote a good framework for the laws of our country, but are to be honored for taking on this fight. there were many imperfections (remember the rights of white men to I think a very strong argument to maintain and properly fund the tn black men?). Times change and so must we/you. medical school is to pose a simple question: who would be the likely Speaking of times changing, Dr. Stodd, you must get over using ‘60’s patient of a UH Medical School graduate? The answer is quick and cliches when describing Rosie O’Donnell’s gun control stands. She is easy—ourselves, our parents, and our children. neither “I.Q. challenged” nor a “bleeding heart” (are the NRA folks then It’s even more ridiculous the Dr. Mortimer would consider turning “stone hearts”). Rather, she is a concerned citizen expressing the the medical school into some type of profit center tied to a two tiered opinion of the vast majority of Americans, including almost all- tuition program for in state and out of state residents. What’s next, a responsible medical societies. silent auction for admittance? The tragedy of the thousands of lives lost every year due to firearms Additionally, just how will doctors in our state stay abreast of the must be controlled. Even yj would not demand a double blind, most current changes in their field without amedical school within 2500 crossover-controlled trial to accept the fact that there is a compelling miles of them? relationship between the number of guns and the number of shootings. I’m a big sports fan and a businessman, but I’d rather ditch the athletic I would like to make one last suggestion, Dr. Stodd. Put five dollars programs and the school of business before under funding the medical in your pocket, get into your car, drive to the nearest Starbucks, order school. a triple cafe mocha latte espresso cappuccino and WAKE UP! In the interim, I’ll keep saving so that my kids can attend college on the mainland. George L. Druger, MD

Very truly yours, Name Withheld by Request Following is my reply to the open letter addressed to me by George L. Druger, M.D.

An open letter to Dr. Russell Stodd, editor of the Weathervane Column. To the editor: Interesting and thoughtful comments from Dr. Druger. Unlike his Sir, apparent position in speaking for the “vast majority of Americans, In the August 1999 issue of the Hawaii Medical Journal, you stated your including almost all responsible medical societies,” I speak only for opinion on gun control clearly and concisely on your Weathervane myself. Perhaps he has misinterpreted my remarks in the August 1999, page. Lest anyone read your opinions and believe that even a small Hawaii Medical Journal. A less emotional reading will reveal that at no minority of physicians agree with you, I am compelled to respond. time do I defend or condemn firearms in this country. Dr. Stodd, you seem to believe that the solution to the rash of recent I am not a lover of guns. As a Korean War Marine Corps rifleman, I shootings in America would be to eliminate parental apathy, eliminate qualified as a sharpshooter with all small arms from the Navy .45 semi one-parent families, improve school attendance and send our children automatic pistol to the BAR, but I retain no affection for guns. I have no to private schools where they have no shootings because teachers can firearms in my home, own no guns and harbor no sympathy for the NRA. communicate with parents.” Sound idea, but... However, irrespective of my or Dr. Druger’ s attitude, guns are part of American culture, and that is not likely to change. I have a slightly easier and more practical solution. The addition of further “gun control” legislation is based on the assumption that somehow these teenage shooting episodes can be 1. All guns are to be registered. eliminated with more laws related to the use of guns. I wish it could be so. Laws made no difference when the determined boys broke the lock 2. All gun owners must be licensed to use the gun by passing a written on a gun case for their shooting rampage. Also, it was obvious that they test and a practical examination (e.g., prove they know where the safety were well schooled in how to use the guns, so the problem goes much is and how it works). deeper than licenses, examinations, permits, safeties and locked cabi nets. Possibly, even Dr Druger would agree. The Springfield, Oregon, 3. Children under 18 years of age can obtain a permit to use a gun, with and Columbine High School shootings, among other school teenage a licensed adult present, after passing a written examination on gun shooting events, stem from serious social problems. In every case, the safety. parents had no idea what the children were doing or thinking, much less what might have generated their sick behavior. 4. Gun owners can and should be held liable if they were negligent in The point of my paragraph in the August HMJ was to scold posturing securing a safe location for their gun and if the gun was used in a crime politicians who seize upon a minuscule item like gun safeties as an or a firearm accident. attempted solution while ignoring the underlying societal ailment.

Yes, I know—”Second amendment, the right to bear arms!! !“ Of Russell T. Stodd, M.D. The Weathervane, HMJ

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©1999Galderma Laboratories,Inc. ogy/History, Biology/Biochemistry, Biology/Biomedical Science, Biology/Chemistry, Biology/Public Health, Education, Business, Medical School Hotline Chemistry, Communications/Public Health, Health, Exercise Sci ence/Biology, Human Biology/Epidemiology, Human Biology, Liberal Studies, Liberal Studies/Pre Med, Marketing, Physical Student Profile: Class of 2003 Education, Physiology, Pre-Professional, and Premed/French/Bio A At the John Burns School of Medicine medical Sciences. (JABSOM) The twelve-member Admissions Committee that recommended Satoru Izutsu, PhD, Associate Dean Chair, Admissions Committee the sixty-two for the class beginning in 1999 to the Interim Dean of the School of Medicine, Dr. Sherrel L. Hammar, was composed of clinical, basic science and other faculty. There were six men and six women who represented the major ethnic groups in Hawaii as well Thirty-five men and twenty-seven women entered the Class of 2003 as age levels. The Committee met twenty-times between September on August 2, 1999. Fifty-three were selected from 1096applications 1998and April 1999 to rate 206 applicants (10 from the Imi-Ho’ola of which two hundred six qualified to be interviewed. Nine Program). The rating ofeach candidate is conducted in a secret ballot graduates from Imi-Ho’ola, the Post-Baccalaureate Programjoined format (1-10) after examining and discussing the following docu the class to make a total of 62. (The Imi-Ho’Ola Program addresses ments: Hawaii residency status, academic scores (Grade Point diversity and those who are educationally-socially, and economi Averages and scores from the Medical College Admission Test cally disadvantaged.) They make up the 32°”entering class and the MCAT), two interviews, essays that address the questions, “Why 11”’class to be trained in the Problem Based Learning (PBL) medicine?” and “Why the John A. Burns School of Medicine?”, at curriculum format. least two letters of recommendations, a biographical sketch, and Fifty-five are Hawaii residents and 7 are nonresidents who come transcripts via the American Medical College Admissions Service from American Samoa, Guam, California, Kansas, and Maryland. (AMCAS). Credits are awarded for clinical/health related and Twenty-one are reapplicants who have applied to John A. Burns human services experience (i.e. employment, community services, School of Medicine (JABSOM) at least once prior. extra-curricular activities) and related research/graduate studies. In The average age is 24.20. JABSOM is the most ethnically diverse addition, the Chair of the Admissions Committee who is the Asso school of medicine in the United States with 17 Japanese, 13 ciate Dean of the School of Medicine interviews all applicants. Caucasians, 7 Chinese, 7 Filipinos, 4 Hawaiians, 4 Other Asians, 3 During the third week of April, the ratings were ranked and letters

Koreans, 2 Samoans, 1 American Indian, I Chamorro, 1 Mixed of acceptance sent to the top 53 candidates.

Asian, 1 Other Hispanic and 1 Vietnamese. The entering class’s MCAT scores in comparison with the na Thirty-five percent are graduates of public high schools and forty- tional norms are competitive (the 1998 national norms are in two percent from private high schools in Hawaii. The remaining parenthesis). JABSOM students scored: Verbal Reasoning 9.0(7.8); numbers come from high schools in the Pacific Islands and main Physical Sciences 9.47 (8.1); Writing Sample Q (0); Biological land. Sciences 9.90 (8.2) Twenty-six are graduates from colleges in Hawaii (23 from Each first-year student is assigned a faculty advisor who main

University of Hawaii at Manoa, 1 Brigham Young University, 1 tains contact with the student throughout his/her academic years.

Chaminade, and 1University of Hawaii at Hilo); thirty-five are from The sixty-two bright, motivated students have begun theirjourney mainland colleges and one from a foreign college (International into the next millennium. They have been carefully selected to Christian University, Japan). The mainland colleges represented succeed in their training and education to become successful physi are: University of Washington-Seattle, Brown University, Univer cians who will continue JABSOM’ s educational tradition as life sity of California-Berkeley, University of Southern California, long learners to serve the communities that they will select to serve. University of Pennsylvania, Amherst College, Boston College, California State University-Fresno, Emory University, Hillsdale College, Mt. St. Mary’s College, Oberlin College, Occidental Col lege, Pennsylvania State University Main Campus, Santa Clara, Seattle University, Smith College, Stanford University, University of California-Irvine, University of California-San Diego, Univer sity of Colorado at Boulder, University of Kansas, University of Notre Dame, University of the Pacific, and Washington University. Ninety-eight percent have their Bachelor degrees. Seven students have Masters degrees of whom one also has a doctorate and another with two Masters. The sixty-two students have majored in: Biology, Psychology, Zoology, Biochemistry, Human Nutrition, Anthropol ogy/German, Anthropology, Anthropology/Public Health, Epide miology, Asian Studies, Biological Basis of Behavior, Behavior, Biological Sciences, Biology/Economics, Biology/English, Biol ogy/Foreign Language, Biology/History & Social Sciences, Biol

HAWAIIMEDICALJOURNAL, VOL58, NOVEMBER1999 298 Hawaii

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insurance Dr. Thomas Whelan, Jr. A True Gentleman and Scholar Written and spoken by Bradley Wong MD, Saturday, September 18, 1999.

I was fortunate to have been one of Dr. Tom Whelan’s residents in by force or coercion, but by the power of example. It was subtle yet general surgery from 1975 to 1980. He was a great teacher, mentor, unquestionable. So stealthy was he, he got us thinking we thought and friend. He was a brilliant man. His intellect and memory were we had original thoughts. It was the Tom Sawyer phenomenon at its superhuman. His administrative and organizational skills were best: we whitewashed his fences and seemed to enjoy it. extraordinary. His surgical skills and daring, unsurpassed. When It was a privilege and an honor to have served under Tom Whelan. you stood next to him, his charisma enveloped and embraced you, He required your best effort. He of course invented the phrase his mental hold on you was firm, inescapable. “attention to detail.” He meant it, his motto, our mantra. Yet in addition to his intellectual prowess, he was an insightful Tom Whelan expected, demanded, your dedication, your devo person and had a wonderful talent for helping others. He cared about tion to your work, to your patients. For our own benefit hejerked our his residents. Though he bullied and inspired us into learning and chains, chided our ignorance, spurred us to do better. It was to insure doing good for patients, he had a huge heart and that we gave the best care to our patients. That soul. He saw everyone through each of their was his ultimate goal: to turn us into real individual trials and successes. He had a great doctors, skilled yet caring, his own image. humanness about him which endeared him to us We were, and still are, striving to meet all. I have met no other man with such afantastic his standards of excellence. He was the gold mix of attributes. standard. He knew it. We knew it. But one of As a chief resident, I initiated the “Teacher of the beautiful aspects of this man, was while he the Year Award.” Our first winner, there could knew we would never better him, he took great be no doubt, was Tom Whelan. We had to give pride in each of our achievements and accom him a “permanent” award so as to allow others plishments. a chance at achieving the honor. The entire He cared for each of us and treated each medical community has benefited from this of our problems, great and small, with great man’s work. He has affected even those who compassion, understanding and fairness. He have never met him or heard of him. Those he expected us to do well at all times, but knew that taught have taught others, but the impact of his we could not be perfect at all times. achievements goes beyond this chain of dis He was both fatherly and dictatorial, ciples. He influenced the entire surgical com forgiving and relentless. No resident’s problem munity by the knowledge he shared and the was too insignificant nor overwhelming. He moral standards he set. shepherded many of us through hard times. I was honored to have been asked by his Patiently he advised, cajoled, threatened, en family to speak at his memorial. What follows Dr. Brad Wang and couraged, and entertained. Teacher-of-the- Year Whelan are some of my words and the words of others He set the standards for both the medical who spoke that day. and surgical communities. He was inspirational and a master “Tom Whelan was my teacher and good friend. He trained me. I diplomat. The power of his intellect and his boyish charm won the love this man. In his later years, he became close to my dad, who’s cooperation of the surgical attending physicians, despite their noto in the audience now. My dad gave me my genes, my nearsighted rious super egos. He fueled and charged the surgical residency ness, and my kidney stones. My second father, Tom Whelan, gave program. to me one of the greatest gifts, the joy of surgery. His vast knowledge trickled down through his students and peers There was good reason why we who served as residents with Tom and became amplified. Even now, we carry out his legacy in the Whelan called him the GENERAL. Though he was definitely a community. Many a patient who has never heard of Tom Whelan is civilian when he became chairman of the department of surgery, I benefiting from his influence. don’t believe he ever read or ever got the letter from the army that I believe that all of us who came under the influence of this great officially retired him. Everyone around him, secretary, student, man are following his example of doing good for our fellow man. resident, faculty, family, knew exactly where one stood with Tom Whelan would like that. He’d be proud. He would like it that him.. .BUCK PRIVATE. his humor, generosity, and kindness have had great and beneficial There was no doubt in anyone’s mind that he was born to lead: not effects on his friends, He would want that we would set an example

HAWAIIMEDICALJOURNAL, VOL58, NOVEMBER1999 300 for others. most likely. I loved his sense of humor, at times impish, always disarming. It Tom Whelan, you were the doctors’ doctor, the students’ advo took the sting out of his bite and defined the joy of his job and life cate, the patients’ friend. and of the relationships of the people around him. Rarely did I ever You were an extraordinary healer, teacher, leader, and friend to us see him without a smile or a laugh. all. You remain greatly admired now, as you were when in your He was joking with me in the days before he died. I was turning prime. We are all grateful to have known you and to have felt the the tables on him, testing his memory. He knew it. Really, he still power and grace of your presence. We are better people for it. had that leprechaun grin on hisjowl. He’s probably prancing around You would appreciate how my young friends would address you right now on this very stage singing McNamara’s band. Off key, now. “You da man, Tom Whelan, you da man.”

Yale Universir days: class of 1943

HAWAIIMEDICALJOURNAL, VOL58, NOVEMBER1999 30i Dr. Whelan By Peter Barcia MD

Dr. Whelan at first MASH hospital, Korea 1951. Courtesy of Life Magazine.

I came to Tripler in 1965,interested in Ob-Gyn. In my 2 month of tracted last illness, and many other credits. I didn’t know any of this; a rotating internship while working alone on the Neurology Service, I only knew that he liked me, and that he wanted me to become a I evaluated a Samoan chief with headaches and erratic behavior; I surgeon. I wasn’t yet convinced, and started an Obstetric residency concluded that he had an insulin producing tumor of the pancreas. in Georgia. Six months later, I told Dr. Whelan that I wanted to be Eventually, I presented this case to Dr. Whelan at the GI Confer a surgeon, and I wanted to be in his program at Tripler. Unfortu ence. He invited me to observe the operation. The chief went back nately the An-nybureaucracy decided to “teach me a lesson.” Dr. to Samoa cured of hisproblem, and I began a wonderful relationship Whelan came to the rescue. “Don’t punish him or I’ll resign!” He with a man who was to become my teacher, mentor, father figure and made an additionai spot for me and I returned the next year to be his our friend. resident. When COL. Whelan came to Tripler in 1965, he already had an General Surgery residency, then as now, entails IOO+hrs/wkin the international reputation as a vascular and trauma surgeon, he had hospital for 5 yrs. It was demanding, and Dr. Whelan was demand served as a surgeon at the front in Korea when the Chinese entered ing. but it was also interesting and exciting, and I loved being a the war and forced a retreat from the Chosun Reservoir in the middle surgeon. of winter and a risky evacuation by sea from North Korea, he had On Sunday mornings at 7AM, all the residents and staff gathered cared for General of the Army, Douglas MacArthur, in his pro- for Grand Rounds, during which we saw every patient on the service.

HAWAIIMEDICALJOURNAL, VOL58, NOVEMBER1999 302 These rounds frequently went until 11 or 12 o’clock. At 8, rounds War College or other service schools, or done the other prerequisites were suspended while Dr. Whelan went to the chapel for Mass; you for this promotion. Instead he was merely a consummate clinician, didn’t have to go to Mass.. .only it was ‘better’ if you did. Most did. a wonderful teacher and role model, and internationally known in After rounds, the residents frequently stayed until 3-4PM to finish Surgery. They created a special job for him: Medical Corp Affairs. up what was directed that morning. He was in charge of all physicians in the Army. In this he was a huge The patient always came first; Dr. Whelan was always at the success, he traveled extensively, met all his constituents, and lis hospital, and you knew he expected the same of us. One Monday tened. His efforts resulted in increased pay for physicians, better morning early in my residency, I met Dr. Whelan as I entered the training opportunities, and better career choices. He gave doctors a ward. He noted my “new” sunburn; I became acutely embarrassed powerful voice in the bureaucracy of Washington. Inmost hospitals and stammered that ‘my wife made me go to the beach!’ he visited, he operated with the surgeons. At the time, he was easily Another resident, Dick Dorazio, commenting on Dr. Whelan’s the most respected and popular senior physician in the Army, and work ethic: let’s not do it now, let’s do it tonight when everyone is many expected him to be named the next Surgeon General. Unfor tired! One night at 2AM, during an emergency operation, Dr. tunately, political decisions were made and he was bypassed for Whelan ordered a frozen section; I asked if I should call a patholo promotion. The upside of this was he came to Hawaii, for a second gist. He responded. “If Dr. Barcia, and Dr. Dorazio, and Dr. Whelan career. can be here, EVERYBODY can be here!” As Chairman of Surgery at the University of Hawaii, he main I accompanied Dr. Whelan when he was counseling the wife of a tained close ties with Tripler; he gave Oral Boards and attended the man critically ill. (I thought that he had no chance.) “Your husband GI conference monthly for 15 years. All our residents rotated with is too sick.. . not to have an operation.” I was incredulous, but silent. him at Queens, and he sent his residents to Tripler. There in 1981, The patient went home after surgery. Ioperated upon Dr. Whelan for a tumor of the stomach. Several days In 1967, Dr. Whelan obtained $1,000,000 to develop a surgical postop I noted his hemoglobin was low. I prepared myself as I went facility at Tripler. As a vascular surgeon, he was interested in a in to see him. He was ready for me; after pleasantries, he asked me problem which had vexed surgeons since they started repairing about his hemoglobin. I responded that it was low, and that we injured blood vessels; why did arterial repairs clot when the vein was would give him iron and this would take care of it. He said, “How also injured? I was given this project to solve along with several of about some blood?” I told him that with his history of hepatitis and his suggestions. Three months and 20 pigs later, I had made some liver problems that I did not think that blood was a good idea. He progress, and Dr. Whelan asked me about his suggestions. I replied said, “Peter, sit down and let’s talk.” After one-half hour, I ordered somewhat off-handedly that I thought they were just suggestions, 2 units of blood. and had pursued a different route. He became quite serious, pointed He never forgot aflame, a face or a promise. In 1972,he told Julie his finger at me and said, “Peter, when I make a suggestion, I mean and Ito keep our house in Hawaii; we’ll bring you back when you for you to do it!” Six months later, we solved the problem, published are ready, and he did. it in the Annals of Surgery, and today it is standard practice to repair Dr. Whelan and Norma became our role models in life; they were the injured artery AND vein. a CLASS ACT. I remember when we were first invited to their large Upon graduation in 1971,he arranged for me to go to Vietnam as home at Ft. Kam. It was anelegant, sit down affair for the graduating Chief of Surgery at the busiest hospital in the country. We commu chief residents; the Whelan daughters served the food, and later nicated frequently. as he was very interested in my cases, experi danced the hula and the Tahitian. The Whelans put everyone at ease. ences, and pictures. It was an unforgettable time. I lobbied with him A splendid affair which was repeated yearly. They helped us decide to return to Tripler right away as staff, “Gen. Whelan, I don’t need to have a large family, to make the training of Army surgeons my gray hair to teach Surgery!” This impetuous remark prompted him career, and to live in Hawaii. I feel like I’ve lived a dream. I’d to say, “You aren’t ready for the Medical Center yet; you need to hitched my wagon to a star. grow up, learn to manage people, get some experience. I’m sending Three weeks ago as I was leaving Dr. Whelan’s room in what was you to Ft. Jackson, SC: a Developmental Assignment!” Of course, to become our last conversation, he remarked that we were both he was right. lucky and blessed to have the families we have. In 1969, he had been promoted to Brigadier General, an astound We are all lucky and blessed to have known Tom Whelan. ing event in that he had never “commanded”, had never attended

HAWAIIMEDICALJOURNAL, VOL 58. NOVEMBER 1999 303 I A1zmh, Ffl!C banking cial reduced loan things Medical EXTRA fhhorn BEFORE planning fres like package blood professionals THE reduced free BANKING HMA and pressure and h a MEMBER rates discounted Business calling help on HMA BENEFITS 525-6262 people business PACKA6E Banker personal members e financing to e (call help and EXCLUSIVELY da can collect business ou tak The free with from ad least consultation banking 4. antag it thc all e can n AFTER Not of FOR ighhor ser do our and to ices is mention HMA islands) xclusi return reduced discounted / e the MEMBERS fees fa mortgage on or TiEpoweroFyes, finan With

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Noa Emmett AluliMD

Ha ‘alelekoa wa‘a, i koa kanaka to discuss my na ‘au(gut feeling) for what was most important to me: the koa canoe has departed leaving the warriors behind the holistic improvement of the health conditions of us Hawaiians. So to Dr. Whelan, we called you Doctor General, you’re a major E ho ‘opiha i ka makalua i hakahaka part of the credit for: my career as a physician, my Hawaiian fill the holefrom which the plant has been removed activism, the ending of the bombing of Kaho’olawe, and now the Aloha Kakahiaka, Aloha Mai, Aloha Kaua: restoration and remediation and of the island. Aloha to this day Many times, when seeing patients pre and post operative on Tothosefrom this place - and they whohave gone before us Moloka’i, or while walking upon Kaho’olawe, or swimming in her And Aloha to you waters, I have acknowledged Dr. Whelan, as I do the many kupuna (elders) who have stood behind me and my work, and upon whose Greetings from Molokai, where I work as a primary care physician shoulders we stand today.You have lifted us up, especially when and am a Co-Medical Executive Director of the Moloka’i General issues have complicated our work. Hospital, (a Queens Health System company), with Dr. Phillip As Hawai’i had their ali’i—Kamehameha, Lunalilo, Emma, Waiholo Reyes - who also sends his aloha and from Kaho’olawe, Kapi’olani, Liliuokalani and Pauahi, whose legacies continue to where I roam. Indeed this is an honor to be asked to share some improve upon the health and wellness of their people—so too thoughts and memories, in honor of a truly great man. Mahalo, JABSOM has her patriarchs—Dean Winsdor Cutting, Dr. Charlie Christal, for reconnecting me with your father, and family. Judd, Dr. Fred Gilbert. My first encounter with Thomas Whelan was in 1968-1969. I was Dr. Thomas Whelan joins them, men of a distinctive quality, men teaching at Damien Memorial High School: mathematics! And I was who have laid a solid foundation for our medical school and resident the school’s swimming coach. A number of my students and athletes training programs for Hawai ‘i and the Pacific. were living at Fort Kamehameha—but I was most interested in I recall an article in 1990, at Dr. Whelan’s retirement celebration checking out the surf at O’ahu military bases. It was there I met Dr. dinner, of a congratulatory note from President George Bush which Whelan, and his family. “Small-kind” discussions. However he I quote: “Your legacy will be the hundreds of physicians who, trusted me more as a chaperone for his daughter Sally and her because of your tutelage and inspiration, will continue to save lives friends. and ease suffering.”! will never know if Dr. Whelan played anyrole, In 1969, 1entered the University of Hawai ‘i medical school and asdidRepresentativePatSaiki.inendingthebombmgof Kaho‘olawe. we were waiting and hopeful for notification that Dr. Whelan would Mahalo Dr. General anyway. And mahalo today, to the Dr. General, join the faculty in order to begin the third and fourth year of medical as now there are: more than 1500 JABSOM graduates, more than training at the University. 190 kanaka mao/i physicians, and more than 60 percent of the My second encounter was in 1975 and 1976 when Dr. Whelan physicians practicing in Hawai’i are either JABSOM graduates, or became the Professor/Chairman of the U of H School of Medicine, physicians trained in the UH Integrated Residency Programs. Department of Surgery and Director of the Internship / Residency So to you Dr. Whelan, your lasting legacy is a mahalo for allowing programs. I became one of his first “interns” in the (FLEXIBLE) people, like us, to compete and collaborate in the advancement of Integrated Transitional Residency program. a first-year Surgical I medicine. Our work is to organize the graduates and faculty to Family Practice Residency program. position ourselves for the next century of quality health care and In January, 1976, I “occupied” Kaho’olawe, (knowing that Dr. wellness in Hawai’i Nei. Whelan was a trauma surgeon!) and continued to to do so on my 48 hours of rest between the 72-hour call schedule at QMC Emergency Room. Unlike other faculty and administrators, Dr. Whelan took the Ha ‘alelekoa wa‘a, i koa kanaka initiative to support me, because what I did while off duty was my as you have departed, who willyou have left the koa canoe to, own time, even though QMC became the “staging” ground for the having departed leaving the warriors behind Protect Kaho‘olawe ‘Ohana’occupations. If convicted with afelony, F ho ‘opiha i ka makalua i hakahaka practice medicine anywhere. I know today, I would not be able to and who wilifill the holefrom which you have been removed that Dr. Whelan believed in me, but probably was confused with my motives and risks of being charged with “conspiring” against the Wewill! US Government. ke ka o ke As Dr. Whelan and I talked about my confrontation with the Navy, Naha kanaka, hale aloha we are broken as men, and your house of love is grieved by I acquired the guts and bravery to sit across the tables from military your belovedpassing brass such as Generals and Admirals, because I was able to do so with him. Dr. Whelan had set me up with clarity and determination Halia Aloha -fond memories, Dr. Whelan

HAWAHMED}CALJOURNAL, VOL58. NOVEMBER1999 306 - -Th

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2036 Hau Street, Honolulu, HI 96819 Phone (808)842-6600 Fax (808)848-0663 [email protected] Thomas Joseph Whelan, Jr. MD A Remembrance By Sharon Whelan Weiss MD September 18, 1999

When I was eight years old, my favorite television series was about empathize with the person. Administrators have a fancy word for a Scandinavian immigrant family making their way in America. this now, “non positional negotiation.” Dad thought it simply the Their lives were a series of challenges made all the more difficult by decent thing to do—itwas, to use the Yiddish expression, being a their lack of financial resources. But they were told by their parents “Mensch.” He could predict outcomes by simply understanding the that there was a cache of money hidden in the house that they could nature of the people involved. After caring for General Douglas tap if needed. Each week I marveled at how they drew on each MacArthur during his terminal illness he delivered a brilliant analy other’s strength and ingenuity and never used the hidden money. sis at a medical meeting of how this great man’s personality and Only later did I realize there had never been any hidden money, but idiosyncrasies had figured so prominently in his illness. Long after their wealth had been each other. So it was with our family. It was I left home Dad continued to be my best resource for advice on any our strong sense of family, largely derived from my father which number of professional issues that might arise, although his advice became the fabric on which life’s early lessons and values were was often couched in athletic terms. Complaining to Dad that there embroidered: love, loyalty, honesty, and fair play. He insisted on were colleagues who didn’t seem to know what was going on he obedience to him and respect toward my Mother, who was never would say, “There’s always someone in left field.” Encouragement referred to as “She” but always as “Mother.” His rules were tough might come in the form of “Hit that ball!” If you abdicated and by today’s standards even prudish—no lipstick until one’s 6 responsibility or quit too soon, he would say, “So, it’s coach take me birthday, and no red nailpolish—never. Bad language was unthink out, is it?” Hassles with administrators would lead to one of his all- able. When we complained as adults that he had been too strict a time favorite phrases, “Don’t mess with the Indians, go to the Chief.” parent, he enjoyed telling us that was why we had turned out so well. He was pleasantly surprised one day when I gave him some advice Above all, Dad taught us to laugh. We laughed at life’s incongru and told him to do the “full court press.” Thinking that somewhere ities. We laughed at ourselves. We even laughed at Dad. Returning along the way his eldest daughter had finally learned something home after an all night ordeal with a very sick patient, he thrilled us about sports, he was flabbergasted to find out that my understanding with the story of how he resuscitated his patient by banging on his of the term had something to do with having one’s clothed well chest until one of us interrupted, “What’s so special about that, that’s pressed when one made official appearances. My father had so how you fix everything around the house.” many friends and grateful patients. Under the Christmas tree each My father placed a high value on education. His parents had year would be a bounty of gifts—homemade kim chee from a worked hard to send him to Andover and Yale University. He repaid Korean patient, an embroidered sampler from a young girl, and them with this exceptional performances both in the classroom and bottles of scotch and bourbon from appreciative anesthesiologists. the playing field. In turn he encouraged each of us to realize our full Despite all of my father’s accomplishments personally and pro potential. He always insisted that gender was no barrier to achieve fessionally, he was fundamentally a modest person. It was said that ment. As a young girl I grew up believing that I could do anything he received a nearly unanimous vote to be Captain of the Yale I wanted to but he did caution me that I could not have both the rights baseball team of 1943. The only dissenting vote was his own. He of men and the privileges of women. I must decide which. What a was not afraid to admit error. At the wedding of my younger sister, wonderful first mentor! He displayed largesse toward me at the time Rosemary, he asked my forgiveness for his initial reluctance to of college applications. I had a deal with my father that I would accept my decision to marry my husband. With tears in his eyes he attend the college which gave me the largest scholarship. On said “With Rosemary’s wedding, God has given me a second acceptance day I received an acceptance letter from my first choice chance, I don’t deserve this chance, but God has given it to me college, Wellesley, but without the badly needed scholarship. A anyway.” With such words I knew I was in the presence of a great second acceptance letter arrived from the University of Chicago man. with agenerous stipend. With aheavy heart I showed Dad the letters. My father was a happy man endowed with greatjoie de vivre. He To my great surprise he gathered me into his arms and said, “Any loved parties and social events of all kinds. He was famous for his daughter of mine who gets into Wellesley will go to Wellesley rendition of the song, “McNamara’s Band,” a command perfor College.” And so I did. mance at the end of many parties. He would truly regard today’s Although well-educated in traditional ways, Dad possessed an event as a celebration of his life. He would have so many wonderful even more amazing wisdom about people. With his extroverted things to say to all of you. He would thank Tom Kane and Ted personality heknew instinctively how to bring out the best in people. Harada for their tireless efforts over the last few months on his His approach to solving a problem was to try to understand and behalf. He would be so proud that Emmett Aluli, a member of

HAWAHMEDiCALJOURNAL, VOL58, NOVEMBER1999 308 Hawaii’s first graduating medical school class, and Brad Wong, one and selflessness, Rosemary’s warmth and compassion, Sally’s keen his of former residents, would speak to you. Both symbolize his intellectand spirit,Christal‘ sdedicationto scholarship,andMichael’s dream of a four-year medical school in Hawaii. He would remember ebullience and humor. As for me, I was his “Beansie Anne,” a with Peter Barcia the importance of training military and his impact nickname dating back to his struggling medical student years when on young military doctors. He would be pleased that Tom Rienzi, we must have consumed a lot of beans. As the eldest child, I was the his friend and walkmate, would assist in celebrating this Mass for responsible one, the one who would catch hell (I mean heck) if him. He would be touched that his brothers and sisters, Mildred, something went wrong, but also receive abundant praise for success. Maryjane, and Bill had traveled so far to be part of this tribute. He Of my mother, his high school sweetheart, he would say little, forhis would be sad, of course, that Charlie Judd, his Yale classmate and smiling Irish eyes would proclaim his love. But above all my father lifelong friend, and his beloved brother Bob could not be here. He would want you to know, the lesson I learned long ago. There is no would tell you how much each of his children meant to him—each hidden wealth in this world, the wealth is here amongst each other. a special person with unique talents. He admitted T.J.’s generosity

The Whelan Family

(Standing from left: Michael Whelan, Christal Whelan, Norma Whelan, Thomas J. Whelan, Jr., Thomas J. Whelan III. Kneeling from left: Rosemary Polen, Sharon Weiss, Sally Whelan.)

Sharon Weiss, M.D., the eldest child, is a pathologist and co-author of the book Soft Tissue Tumors. She received her medical and residency training at the Johns Hopkins Hospital and has held positions as Chairman. Department of Soft Tissue Pathology oft/ic Armed Forces Institute of Pathology, and thefirst A. James French Professor of Diagnostic Pathology at the Universiti. of Michigan. She is currently Professor and Vice Chair of Pathology at Emory University.

Thomas J. Whelan JIj, first-born son, is an English teacher at Farrington High School in Honolulu, Hawaii. This year he completed a ten-year project — afamik history of the Whelans — that led him to places asfarfiung as the NarionalArchives in Washington, D.C., and local parishes in Ireland.

Rosemary Polen, RN., works in thefield of health and weliness in . Maryland where she specializes in cardiac rehabilitation, senior fitness, and weight reduction. She also coordinates and acts in independent theatrical productions.

Sally Whelan is the special projects coordinator at the Boston Women‘sHealth Book Collective, a women ‘shealth, education, and advocacy organization renowned for the bestseller Our Bodies, Ourselves. Shefacilitates the translations and adaptations oft/ic book by women’s otyaniza tions around the ny),.ld most recently in China and Thailand. c’hristal Whelan, author and visual anthropologist, resides most/v in Japan. Her book — The Beginning of Heaven and Earth: The Sacred Book of Japan’s Hidden Christians — has received international recognition along with her documentary — Otaiya — scheduled for screening at this year’s Margaret Mead Film and Video Festival at the American Museum of Natural History. She is currently working on aflim about the tango in three cultures: Japan, Finland, and Argentina.

Michael Whelan, graduate oft/ic Culinary Institute of America (CIA). andformer chef at the Halekulani Hotel’s La Mer restaurant, current/v teaches culinary arts at Scottsdale ‘omnmnunirvCollege in Scottsdale, Arizona. hard by today. that three years a My spring accomplishments to close a life large My He all my father family to far family family. was I that father straight father’s came find Irish away the was he made a generations, Catholic to knew place only did. He from born from mother see the would we I one how that in the journey see and the

Eulogy have America family. and circle of much much qualities that grew be since his heard father. so Dr. from everything of brothers was up he happy emigration It and love Whelan was about held in and Boston expected thrive. Lynn, that to and values that and in know when my family to the from still family Massachusetts sisters He be of

father for instilled president remembrances that with knew is, Ireland, him. made. HAWAII a who within, four us, very by became, he He in of and chose But MEDICAL members was had daughter,

Thomas that strong the knew as as with over worked blessed a Pacific part family all to today, guide JOURNAL, him that live and the the of of Coast 310 Sally VOL of to communities residents. kinds how excel to lack of in to he support My daily be his be medicine. Surgical care. also 58, of you a in NOVEMBER academically, values. of father Whelan good knew health behavior, a and He people. treat family He Association loved relished person He that, encouragement had insurance people,

J. And throughout 1999 believed that a more with seeing vision those — and his valued to enjoying and

Whelan integrity. than move work, should achieve values that of women Mrs. the training anything education, to healthcare about and Pacific, Whelan. time never were, his excellence He enter his physicians the with was women beliefs else, exclude in medicine, world, and especially was large very people, his in that permeated medical a parents consistant anyone part, his birthright, in to he any and serve and work. in about should endeavor respecting expected from students gave underserved in his But in and their people— strive practice holding the endless I that think own best him and and all to a areas. Occasionally, we would meet his students and residents with enjoy something. Short-term memory was hard for him, but throw whom he spent much time, and we would joke with them that they him a story about the old days — about a championship ball team he got the better part of his day. Maybe we should sign up if we wanted played on in high school, or a play he made as first baseman at Yale more time with him. Perhaps most importantly in his teaching he — and his mind was at once bright and happy, recalling vivid details insisted that a physician be warm and compassionate with those who of an exciting game. came into his or her care. As recently as a few weeks ago my father Memories sustained him; he would dip into them and come up told me how wonderful his work had been — what could be better, he smiling. Sometimes, after sitting poolside, he would come into the said, than being able to help people everyday in such a meaningful house and say to my mother, “We have such a great family. It really way. Untold numbers of those who came into his care were grateful has been a very good life.” What a blessing to be able to sum it up for his medical talents and, equally, for his deep humanity. that way. It was a very full life. He was a baseball player, an army My dad loved humor, but he was also a serious man. You could general, a physician, a teacher, a husband of 55 years, and a father play, but life was not to play around with. A life was to be all you of six children. And yet with all this he was strikingly unpretentious. can be. Work was not an endeavor for bringing in wealth, or even He was many things to many people. Some, but by no means all, of primarily about success and acclaim. Work was doing what you the people he touched are here today. love, giving it your best, and the rest would follow. Being a parent was not about going along with what all the other parents were doing And now he is gone. or allowing, but holding fast to your values and imparting them to your children. Sometimes he met resistance, during our teen years, He never seemed afraid to die. He was humble about death, but in certain of our life decisions that he did not understand or approve thought it as natural as breathing. At the burial of my grandfather, of, or in differences in values. What strikes me now about those Papa Gianascol, I sobbed as they lowered the casket. My father times is that after the initial differences he had the bigness of walked over to me, put his arm around me and said very tenderly, character to be open. He once told a friend of mine that his children “Darling.. .all you can do is let go.” were his teachers. He said we forced him to stretch, we made him embrace things he never imagined he would and, in this way, we Now, we are trying to let go of you, Dad. And.. .we are holding you widened his world view. This was nice to hear, but I give him most with us forever. of the credit. Because he, more than anyone I know, learned from his mistakes, took them to heart, and really did try harder the next We are gathered here to honor and remember you. You would love time. Would that we could all say that about ourselves. this gathering of the people you loved. Over the years he stretched and mellowed. He retired, and remained very active tutoring, consulting, and lecturing. And then We are with you wherever you are, and we are going to miss you over three years ago he had a stroke that took way too much from terribly. him. Fast-moving conversations because confusing; he still was gregarious, but social gatherings could be hard; and activities he We are very lucky to have had you in our lives. God bless you, Dad. loved were no longer possible. The days could be long. Somehow, though, his sunny nature endured, as well as his ability to always

Dr. Whelan becomes a brigadier general: pinning the stars

HAWAIIMEDICALJOURNAL, VOL58, NOVEMBER1999 311 Dr. Thomas J. Whelan... the finest surgeon COL (ret.) Yeu-Tsu Margaret Lee MD

I came to work as a general surgeon at the Tripler Army Medical Center in August of 1983. I did not know Dr. Whelan at first, but I saw his picture on the wall outside the Department of Surgery’s office. Under his pictures, it said: “Brigadier General, Chief of Surgery, July 1969 — June 1971.” I was very impressed, because other Chiefs of Surgery were all Colonels. I was more impressed when I attended his teaching conferences. He used to come to Tripler at least twice a week for GI conference and for the resident seminar. When he was in the room, all the residents and staffs were at attention. He asked questions in such a way, that we did not feel threatened. Not only could he explain complex issues in simple terms, but his analysis of alternative diagnoses made perplexing cases seemed obvious. He had vast surgical experiences and he published many papers relating to arterial and venous diseases)- In addition, all military surgeons should read his reports6 about lessons learned in the Viet Nam war and Korean 7ttconflict. On a personal note, I found Dr. Whelan was a true educator he encouraged women to go to medical schools and he did not discour ii. McNainara MD & Tom Whelan MD (June 1984), leading age women who wanted to be surgeons. Unlike some surgeons who “McNamnara ‘s Band” appeared to be egotistic, Dr. Whelan was always a gentleman. Despite his busy schedule, he and Mrs. Whelan came to one of my dance parties. Later, they also took ballroom dance lessons them selves. Besides his contributions to surgery and medical education, Dr. Whelan has enriched the lives of many, many people. At the annual residents graduation parties, he usually led the crowd in singing “McNamara’s Band.” We’ll miss him, because as the song said: “he is the leader of the band. Although we’re few in number, he is the finest in the land.”

References

1 WhelanTJ, BaughJH: Non-atheroscleroticarteriallesionsand theirmanagement. I. Trauma, Curr.Probl,Surg.1967Feb: 3—46. 2. WhelanTJ, BaughJH: Non-atheroscleroticarteriallesionsand theirmanagement. II. Inflam

matoiylesionsof arteries. Curr.Probl,Surg.1967Feb: 46 — 76. 3. Whelan TJ, Baugh JH: Non-atheroscleroticarterial lesions and their management, Ill. Congenitaland miscellaneousarteriallesions. Curr.Probl.Surg.1967Mar.1 — 47. 4. BarciaPJ, NelsonTG,WhelanTJ: Importanceofvenousocclusioninarterialrepairfailure: an experimentalstudy. AnnSurg1972Feb:175(2): 223—7. 5. WhelanTJ: Managementofvasculardisease ofthe upperextremity.SurgC/inNorthAm. 1982 Jun: 62 (3): 373-879. 6. GreigJD, WashingtonBC,WilsonPP. WhelanTJ: lntraabdominalvenousiniuries. Curr.Surg 1985Jan—Feb: 41 (1/: 20—3 7. WhelanTJ. BurkhalterWE.GomezA.: Managementofwarwounds. AdvSurg1968; 3: 227— 350 8. ThomasGe.WhelanTi: SurgeryinViefNam. JAMA1971Jan 11: 215 (2): 295. 9. Carroll,COP,Cass KA.WhelanTJ: Woundsof the liverin Vietnam:a criticalanalysisof 254 case. AnnSurg1973Apr:177(4): 385—92. Fm-nm the left: Dr. Whelan, Major General James Peek, Harriet (Dr. 10. WhelanTJ: Surgicallessons learnedand relearnedin Vietnam.SurgAnnu.1975; 7: 1 —23. Whelan’s Secretary), Dr. Yeutsu M. Lee. 11. WhelanTJ: MASH.militarymedicine,and beyond: mainstreamor tributary?AmJ Surg1986 Jul; 152(1): 2—5.

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Less Is More: Up to one tablet of ASAJdprotects “You’re going to take my specimen?” he asked THE FEDERAL GOVERNMENTS against thrombolytic strokes, but 2 tablets/d anxiously?” NEW, UNABRIDGED MEDICAL doubles the risk of hemorrhagic strokes... A bit miffed, she replied, “Of, course. Don’t DICTIONARY worry, I’m very experienced at this.” Tourniquet, Vacutainer and 21-gauze needle in Barium: What you do when the patients dies hand, she wheeled around to face the pallid and Urine: The opposite of “You’re out!” ReDorts on AIDS: The HIV Prevention Confer trembling patient. Cauterize: Made eye contact with her ence metin Atlanta.. .Thenumberof AIDS deaths “Oh, frightened of needles, are we? Really,” she Ova: Finished; done with has dropped 60% (Less that 20,000/yr) but the said trying to comfort “it’s him, just a little prick; Dilate: To live a long time decline is slowing.. . However, the incidence of there’s nothing to worry about.” Enema: Opposite of a friend AIDS among Afro Americans has risen from At this point, the young man gave a hoarse cry, Node: Was aware of 50% of all children in 1984to 70% in 1988.. New seized his coat and ran down the corridor and out White count: The number of Caucasians AIDS cases: Afro Americans: 48%; Whites: the exit, never to return. The technologist could Hernia: Pertaining to a female’s knee 31%; Hispanics: 20%; Others: 1% only stare in mute astonishment. Fibrillate: To tell a small lie It was only when the young man’s doctor D&C: Where Washington is called a few days later looking for his test results Bunion: Paul’s surname that the staff realized that “s. . a.. .“ had actually Rectum: Dang near killed him Boning UD: Reloxifene reduces the risk of spinal been intended to read “semen analysis.” Paradox: Two doctors fractures by 50% in women with osteoporosis. Dr. Avis Piton Coronary: Domesticated Yellow Bird Another benefit recently discovered is that the Stitches Nov ‘96 Constipation: Endangered feces drug also reduces the risk of breast cancer by Penis: Someone who plays the piano 70%... MEDICAL TIDBITS II Humerus: To tell us what we want to hear Intestine: Currently taking an exam Hvuothyroid During Pregnancy: A recent SAMe Outpatient: A person who has fainted report shows that women who are hypothyroid Pronounced (SAM-me) and supposed to com Genital: Non-Jew during pregnancy are likely to have children who bat depression, ease aching joints and possibly Sacrum: Holy score 20 points below average on standard intel revitalize the liver. . . SAMe was introduced in Pap Smear: To slander your father ligence tests... the US in March and is afready the 4’ most Pelvis: The evil twin of Elvis popular supplement in drug store chains and Seizure: Roman Emperor From Our Readers general retail outlets. SAMe is surpassing St. Cat Scan: When the Secret Service looks for John’s wort in sales.. .SAMe is short for S Socks The language nerds were testing another com adenosyl methionine (a compound found in every puter translation experiment, English-to-Russian. body cell) which is found in every cell of the POTPOURRI... The test phrase was, “The spirit is willing, but the body and plays a pivotal role in hundreds of flesh is weak.” biochemical reactions in the body as a methyl When I was an intern rotating through urology, The translation returned as: “The ghost is ready, donor. . .Methylation reactions are important in I asked a Scottish lady: “Does your urine burn?” but the meat is raw.” the production of the brain’s neurotransmitters She replied, “I don’t know, Doctor, I’ve never Rex D. Couch, MD and enzymes that help repair joints and the liver. tried to light it.” 4359 Providence Point Place, Italian researchers have documented its anti Dennis Gardner, MD Issaquah, WA 98029 depressant qualities. German researchers feel it Nepean, Ont. helps repair osteoarthritic joints.. .SAMe is still P.S. “Best wishes from retirement and Washing a prescription drug in Europe. Minor side effects ton—Miss you all and great friends and colleagues include hot, itchy ears... on Kauai.” A disgruntled 15-year-old came into the Emer PH: (425) 837-1896 FAX: (425) 837-3581 gency Room, having cut her finger on the meat slicer at her part-time job at a delicatessen... FOOD FOR THOUGHT... Genes of the Heart: Researchers have shown In order to take the young woman’s mind off her that direct injection of the heart with blood vessel plight as I was sewing the wound, I asked her, “So “There is no wealth, but life.” promoting genes is safe and well tolerated and what were you making when you cut your fin John Ruskin that the patients report less chest pain... ger?” “About $5.25 an hour,” came the seriousreply. “Try not to become a man of success, but rather Chris Carter, MD try to become a man of value.” Ritalin: Boys on Ritalin for ADHD (attention Toronto Albert Einstein deficit hyperactivity disorder) are less likely to abuse alcohol and other substances in adult MEDICAL TIDBITS III “The highest reward for man’s toil is not what hood... he gets for it, but what he becomes by it.” (Time Aug 16) Protein Power: Data on 120,000 nurses sug John Ruskin gests that protein from poultry and dairy foods (but no red meat) reduces the risk of dying from “There is nothing more frightening than igno diagnosed breast cancer. . . 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I Left My Glasses In The Bathroom And Now I’m Disabled. stromal bed bears the stress originating from the intraocular pressure. Dr. The Supreme Court of the United States is having trouble with the Ameri Seiler reported that in correcting myopia of more than 10 diopters, kerate cans With Disability Act. How do you define “unmitigated?” The question ctasia may be as high as 3%. Considering changes with age, glaucoma of evaluating a disability in unmitigated state means an untreated medical potential and possibility of rubbing the eyes, what will be the frequency of condition, but does it refer to vision without glasses? Two sisters are suing keractectasia in 10 or 15 years? United Airlines claiming to be disabled, because they fail to meet the standard of 20/100 visual acuity uncorrected. Of course, they both see 20/ To Err Is Human. To Forgive Is Against Company 20 with glasses or contacts. Seven of the nine Justices wear glasses, and they Policy. seemed to have a magical revelation when Judge Scalia waved his glasses The Supreme Court returned a degree of sanity to the judicial process when in the air and said that under these liberal interpretations of the ADA a it ruled that expert witnesses will have to rely on truth. Judges will be able “majority of Americans are disabled.” A United Parcel Service driver with to block testimony from a witness whose theory hasn’t been tested or high blood pressure wants to qualify as disabled because if he stopped his subjected to peer review. After many years of corrupt medical testimony drugs he would have serious problems — although he does take his medica offered by sly lawyers with an agenda, expert witnesses opinions will have tion. The ADA was supposed to increase the number of disabled in the to be based on sound science. In the case of silicone breast implants, David workplace, but actually the number has dropped by 4% since the law was Kessler, M.D. then head of the FDA, reacted to the publicity and banned passed. And no one wants to talk about the JAMA December 1997 study their use. Now, many torts later, and following a score of peer-reviewed that provided statistical support for the notion that workers with sensory studies, including the Mayo Clinic, Johns Hopkins University, University impairments have more than their share of industrial accidents. of Michigan and others, no link was found between implants and various diseases. As spoken by Dr. Marcia Angell, executive editor of the New How To Make A Medical Meeting Into A Firestorm. England Journal of Medicine and author of Science on Trial, “many women The Oregon Medical Association House of Delegates voted to continue to developed symptoms that any woman over 25 could develop” went looking be the only state in the land where doctors can be reimbursed by the state for a culprit, and decided on implants. And along the way, billions of dollars Medicaid plan for providing assistance to suicidal patients. By a vote of 51 have disappeared in the legal system and a major corporation was forced to to 33 physicians elected to keep state funding. Then the House voted to declare bankruptcy. Late at night, introspective personal injury attorneys allow pharmacists to give “morning after” emergency contraception medi must sometimes question the social value of their endeavors. cations to women without a prescription. Doctors opposed to that measure were not happy with ceding the option to pharmacists, and others felt that Frankly, I’m Getting Tired Of Scientific Progress. the morning-after drugs actually are synonymous with abortion in some Technology at the end of the h20 century has struck once again. This time cases. Now, that is the kind of action that keeps delegates from dozing off it is to answer the question on every canine breeder’s mind, is Fifi pregnant? at annual meetings. Yes, the dog’s adopted parents will no longer have to chase the bitch around the back yard hoping to catch some urine, nor wait until she has a blossoming Insurance $$ Vs. Good Legislation. Trent’s Bent. Gotta abdomen. Impatient doggie parents can now take their girl to the local vet Lotta Problems. who can draw a blood sample, send it to a lab that specializes in dog testing, A large majority of Americans (70%) want a strong patient protection act, and in three days the answer will arrive. Of course, the question of but the Republican Senate leadership just doesn’t get it. The Senate bill, a fatherhood can still be a matter of surprise. wimpy measure that could have been written by insurance lobbyists, was passed along party lines. Contrarily, the House seems ready to modify the I Love Mankind. ly’s Just People That I Hate. legislation with what is necessary to curb some HMO abuses. The patient Frightening statistics in population reveal that the world’s human popula protection legislation currently being debated in the House of Representa tion passed the one billion mark in 1804. By 1927, homo sapiens had tives is really somewhat tardy, because the states are far ahead of Congress. doubled to 2 billion, and by 1960 we passed 3 billion, and by 1974 it was 4 Thirty states (including Hawaii) have already provided for the right of billion, and 1987 the number came to 5 billion. 1999 will see 6 billion patients to appeal a negative insurance company decision for independent humans filling the office buildings, airports, suburbs, freeways, inner- review, forty-seven states have banned gag clauses, thirty-fivestates have cities, condos, K-Marts, elevators and bathrooms. Does anyone see a prudent layman standards for emergency room visits, twenty-eight states problem here? provide for health plan disclosure of pharmaceutical restrictions. Get with the program, Senator Lott. If You Live Long Enough, You Find That Every Victory Turns Into Defeat. One For The Road, Mat Be Two For The Cemetery. It is getting tougher for HMOs to compete. Data collected by Weiss Ratings According to federal highway-safety officials, U.S. drunken driving deaths Inc. revealed that more than half of HMOs lost money in 1998. Touted by fell by nearly 2% last year to an all time low in the seventeen years they have planners as the saving mechanism for escalating medical expenditures, 57% been keeping such data. Total DUI deaths were 15,935, still a huge number, of HMOs collectively had $768 million in losses last year. Harris Methodist making up 38% of the 41,471 total traffic fatalities in 1998. Hawaii’s DUI Health Plan in Arlington, Texas, lost $99 million to lead the red ink list. statistics show a similar change through the 15 years the local Mothers Many plans are skating on thin financial ice and are close to insolvency with Against Drunk Driving team have worked so diligently to inform the public lowering reserves. 100 HMOs fell below minimum risk-based capitol and monitor the courts. The Hawaii Medical Association can take some guidelines established by the National Assn. of Insurance Commissioners. credit, because it was through the HMA Auxiliary that the Hawaii MADD These numbers show why so many HMOs no longer want to contract with program was initiated. Medicare. Could it be that the old standard indemnity plans and PPOs aren’t really so wasteful after all? If At First You Don’t Succeed, Redefine Success. Theo Seiler. M.D. is a professor of ophthalmology at the Free University in ADDENDA Berlin, Germany. He was the first to apply excimer photoablation to the +Cocaine users risk of heart attack is 24 times higher than normal in the first human eye in 1986 and presented the first clinical results of excimer hour after taking the drug. photorefractive keratectomy in 1990. Now the professor has reported an +Ancient Egyptians shaved off their eyebrows as a sign of mourning when overview on the complications of their cats died. LASIK, notably iatrogenic keratectasia, the abnormal bulging of the cornea +What happens if you are scared half to death twice? produced with LASIK is loose and has no following laser surgery. The flap +They call it PMS because mad cow disease was already taken. mechanical tension for the cornea for at least the first year, and only the Aloha and keep the faith —rts•

HAWAIIMEDICALJOURNAL, VOL58, NOVEMBER1999 318 LIVE FOR TODAY. BUT MANAGE YOUR ASSETS FOR THE LONG TERM.

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